Finding the surgeon

The first step is to find a surgeon that can do your surgery. You can check out the World Professional Association of Transgender Health (WPATH) provider directory to find a surgeon near you.Let us know your timeline for your surgery. Depending on the type of surgery, some surgeons and insurance companies might require you to have been on GAHT for at least a year, but this is not always a requirement. 

Confirm with your surgeon and/or insurance company that a letter from a medical provider is sufficient. Occasionally, both a medical provider letter of support and a mental health provider letter of support are required. At this time, we do not provide mental health letters of support. Click here for a list of mental health providers willing to offer mental health support letters.

While it is not always required, sometimes your surgeon may ask for a letter of medical clearance before surgery. This is to ensure that you are medically stable to undergo the procedure. If required, this letter cannot be completed by your Plume Clinic provider as it requires an in-office visit. It will need to be completed by your primary care provider. Ask your surgeon’s office for more information on their specific pre-surgery requirements. 

NOTE: The following websites are intended to be a resource to gather information, and Plume Clinic does not personally endorse these websites nor the providers listed in their directories.

For masculinizing surgeries 

• Learn more about the process and find a provider for top surgery

• Learn more about the process and a provider for bottom surgery

For feminizing surgeries

• Learn more about the process and find a provider for bottom surgery

• Learn more about and find a breast augmentation provider. Insurance does not typically cover breast augmentation, so letters are generally not needed for breast augmentation surgery. 

Getting the letter

In order to complete your letter of support for your surgery, your care team will need to know the following information from you.

• What month and year did you start GAHT (Gender Affirming Hormone Therapy)? (Ex: January 2025)

• What pronouns would you like us to use in this letter? (Ex: he/him, she/her, they/them, ze/hir, etc.)

• How should we list your identified gender? (Ex: transgender man, transgender woman, male, female, non-binary, genderqueer, etc.)

• What month and year did you start identifying as such? (Ex: January 2025)

• What month and year did you start living socially as your identified gender? (Ex: January 2025)

• What procedure(s) are you having? Please give us the clinical term, rather than a generic term like 'GRS' or 'top surgery.' We recommend you contact your surgeon before requesting a letter so that your letter will meet their requirements.

• By what date do you need this letter?